Hi all, thank you for reading. I am posting on behalf of a friend who is emotionally exhausted after trying to find some solutions. I was hoping I could assist her in reaching out on here to see if there were any avenues we should explore. She is 35/F, ZIP 48033, makes roughly $100k/yr.
My friend was diagnosed with psoriatic arthritis this past year and has been in agony since. Last month, she was given an injected medication called Taltz – and to her surprise, she felt great for the first time in a year. She has undergone two of the shots. She has BCBS Michigan insurance through a work plan. Her first two injections were subsidized by a program offered by the medication called ‘Taltz Together’. Today, she tried to book her next injection, and was told that she had already met the ‘maximum copay assistance’ on the drug – that there was a maximum assistance of $8000 from the Taltz Together program, and that she had reached that from the first two shots. Her insurance covers the first $26,000 of the monthly cost – but the total bill for another shot would mean that she would have to pay an additional $6,000 per month out of pocket. Her out of pocket maximum is $15,000/yr, but reaching that would still put her in a bad financial place. Is there any alternatives, or are there any tips anyone could offer to ensure she keeps getting her medication?
Thanks so much.
submitted by /u/cc_haha
[link] [comments]Hi all, thank you for reading. I am posting on behalf of a friend who is emotionally exhausted after trying to find some solutions. I was hoping I could assist her in reaching out on here to see if there were any avenues we should explore. She is 35/F, ZIP 48033, makes roughly $100k/yr. My friend was diagnosed with psoriatic arthritis this past year and has been in agony since. Last month, she was given an injected medication called Taltz – and to her surprise, she felt great for the first time in a year. She has undergone two of the shots. She has BCBS Michigan insurance through a work plan. Her first two injections were subsidized by a program offered by the medication called ‘Taltz Together’. Today, she tried to book her next injection, and was told that she had already met the ‘maximum copay assistance’ on the drug – that there was a maximum assistance of $8000 from the Taltz Together program, and that she had reached that from the first two shots. Her insurance covers the first $26,000 of the monthly cost – but the total bill for another shot would mean that she would have to pay an additional $6,000 per month out of pocket. Her out of pocket maximum is $15,000/yr, but reaching that would still put her in a bad financial place. Is there any alternatives, or are there any tips anyone could offer to ensure she keeps getting her medication? Thanks so much. submitted by /u/cc_haha [link] [comments]Read Morer/HealthInsurance